Due to the legalization of cannabis in many states, the use of cannabis or it’s metabolites (CBD, THC and marijuana) have increased. In one national survey of 93,000 pregnant women over seven years, 7% of pregnant women reported any cannabis use in the last 2-12 months during their pregnancy. In fact 16% reported daily or almost daily use . In addition, 70% perceived slight or no risk of harm from their marijuana use. The highest increased use was among 18-24y.o. pregnant women increasing from 13% to 22% over the study period of 7 years. The most common symptom for using marijuana was anxiety, pain, nausea and vomiting of pregnancy. What most people fail to understand is today’s cannabis is very different from even 10 years ago. The concentration of THC (the psychoactive ingredient in marijuana) has gone from the low single digits to more than twenty percent. This is analogous from a swig of near-beer to a tequila shot. Also, street acquired marijuana is very different than prescription cannabis. Street acquired marijuana can have additional properties added to the marijuana helping to induce more addiction.
In social media, there seems to be a false narrative that the use of marijuana, CBD or THC is safe. This aids in the promotion of using cannabis. Some of the products seem “safer” like foods (brownies, cookies, etc), “supplements”, or lotions. This is sometimes confusing to patients as well.
The acute effects of cannabis depends on how it is ingested. Inhalation or smoking causes sudden effects lasting one to three hours while edible can take longer for effects to be seen but last longer as well.
Cannabis effects include :
- coughing or wheezing
- anxiety or anxiety attacks
- euphoria
- bronchitis (chronic if consumed often
- temporary psychosis severe enough to cause admission to the ER
- reddening of the eyes
- convulsions (rare and dose dependent)
- increased appetite
- short term memory loss
- blurred vision
- dizziness
- headache
- sedation
- dry mouth
- people with AIDS may develop opportunistic bacterial or fungal lung infections
- delayed motor reactions
- delayed ovulation-decrease the production of estrogen and without the high estrogen spike, ovulation will not occur
Male fertility effects:
- affects receptors found in the hypothalamus and pituitary gland decreasing the hormone production necessary for sperm production
- decreased sperm concentration up to 20%
- decrease sperm motility (“ability to swim”)
- Inhibited ability to fertilize an egg
- fundamentally changes the sperm itself
Given its psychoactive properties, there has been high interest in there are any short- or long-term neurodevelopment effects on children prenatally exposed to cannabis. Studies from the US, Canada and Netherlands reveal deficits in children in several measures of cognition and behavior with follow-up of those children from birth to adulthood.
The American College of OB/GYN (ACOG) recommends that women who are pregnant or contemplating pregnancy be encouraged to discontinue marijuana use. This discontinuation is also recommended for your partner. With respect to lactation and breastfeeding, ACOG concludes marijuana use is discouraged. The American Academy of Pediatrics (AAP) recommends women of childbearing age abstain from marijuana use while pregnant or breastfeeding because of potential adverse consequences to the fetus, infant or child. In addition in 2019, the US Surgeon General issued an advisory regarding potential harm to developing brains from the use of marijuana during pregnancy and lactation. Lastly, the Food and Drug Administration (FDA) issued a similar statement in October 2019 strongly advising against the use of CBD, THC and marijuana in any form during pregnancy or while breastfeeding.
So, as providers caring for our patients, we at Women’s Care Specialists agree with the recommendations from ACOG, AAP, the Surgeon General and the FDA. If you are struggling with your decision, please feel free to discuss with us at an appointment. We want you to have the healthiest baby and watch that healthy baby grow to a wonderful, emotionally stable adult.
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